Civil Remedy Notice of Insurer Violations
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Filing Number:     791068
Filing Accepted:  11/8/2024
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Complainant
Last/Business Name *  
BRACKEN   First Name   SUSAN AND CAROL
Street Address * 8 EAST SOVEREIGN LANE
City, State Zip * ORMOND BEACH, FL 32166
Email Address * FIRM@FLORIDAINSLAW.COM
Complainant Type: * Insured
Insured
Last/Business Name*   BRACKEN   First Name   SUSAN AND CAROL
Policy # * FE-00008830893-04 Claim #* HO0522412002
Attorney
Attorney is Applicable
Last Name* CIOCCHETTI First Name * MICHAEL Initial
Street Address* 125 N. RIDGEWOOD AVENUE, SUITE 100
City, State Zip* DAYTONA BEACH , FLORIDA 32114
Email Address * FIRM@FLORIDAINSLAW.COM
Violation
Insurer Type *   Authorized Insurer Unauthorized Insurer
 
Insurer Name*   MONARCH NATIONAL INSURANCE COMPANY
NAIC Company Code 15715
 
Name of individual responsible for violation (if any):* ROBBY OSBORNE
Type of Insurance * Residential Property & Casualty   
Reason for Notice *
Claim Denial
Unfair Trade Practice
* Statutory provision(s) which the insurer allegedly violated.
 
624.155(1)(b)(1) Not attempting in good faith to settle claims when, under all the circumstances, it could and should have done so, had it acted fairly and honestly toward its insured and with due regard for her or his interests.
626.9541(1)(i)(2) A material misrepresentation made to an insured or any other person having an interest in the proceeds payable under such contract or policy, for the purpose and with the intent of effecting settlement of such claims, loss, or damage under such contract or policy on less favorable terms than those provided in, and contemplated by, such contract or policy.
626.9541(1)(i)(3)(a) Failing to adopt and implement standards for the proper investigation of claims.
626.9541(1)(i)(3)(b) Misrepresenting pertinent facts or insurance policy provisions relating to coverages at issue.
626.9541(1)(i)(3)(d) Denying claims without conducting reasonable investigations based upon available information.
626.9541(1)(i)(3)(f) Failing to promptly provide a reasonable explanation in writing to the insured of the basis in the insurance policy, in relation to the facts or applicable law, for denial of a claim or for the offer of a compromise settlement.
* Specific policy language that is relevant to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

SECTION I – PERILS INSURED AGAINST COVERAGE A – DWELLING and COVERAGE B – OTHER STRUCTURES We insure against risk of direct loss to property described in Coverages A and B only if that loss is a physical loss to property.
 
* Facts and circumstances giving rise to the violation.
Enter all words or phrases (one at a time) that should be used to filter.

This complaint is made on behalf of the insureds, SUSAN STANLEY BRACKEN and CAROL STANLEY. Further, this complaint is a statement that notice is hereby given in order to perfect the right to pursue the civil remedy pursuant to Florida Statute §624.155. In consideration of the premium paid to it, MONARCH NATIONAL INSURNANCE COMPANY (“Carrier”), issued a policy, Policy No. FE-00008830893-04 (“Policy”), to the Insureds where the Policy provided coverage for all losses, except those losses which were expressly excluded, for the property located at 8 East Sovereign Lane, Ormond Beach, FL 32176 (“Insured Property”). The policy was in full force and effect at the time the damage occurred from Hurricane Ian, and the ensuing damages as a direct result thereof, to the Insured Property, on or about September 29, 2022. Thereafter, the Carrier was timely notified of the Loss. In particular, the Carrier was put on notice of covered direct damages and ensuing damages and of the request that a claim be opened pursuant to the terms and conditions of the Policy. Claim number HO0522412002 (“Claim”) was assigned to the Loss. The Carrier sent an adjuster to the Insured Property to perform an inspection. The Carrier performed a cursory inspection of the Insured Property and failed to retain unbiased experts necessary to trigger the cause of the Loss and covered repairs necessary to restore the Insured Property to its pre-loss condition. The Carrier deliberately denied the claim. The Carrier knows its aforementioned investigation is insufficient and that it has failed to provide proper payment to restore the property to its pre-loss condition. This inspection placed The Carrier on notice of the severity of the Loss. The Carrier subsequently denied the Insureds’ claim and issued no payment for the Loss. Thereafter, the insureds sought the assistance of a public adjuster who ensured the proper estimating of the loss and compliance with all Policy conditions. The public adjuster submitted a comprehensive estimate to the Carrier for the full scope of damages to the Insured Property. In addition, a Sworn Statement and Proof of Loss (“SPOL”) was provided, on or about July 24, 2024. The Carrier disregarded this comprehensive estimate and SPOL and, instead, denied the Claim. The Carrier has refused to reassess its denial of benefits and the basis of the denial and has refused to properly adjust and settle the Claim. The Carrier violated the provisions of Florida Statute §624.155(1)(b)(1) by failing to attempt in good faith to resolve this claim when, under all circumstances, it could and should have done so had it acted fairly and honestly toward its insureds with a due regard for their interest. When the Carrier was confronted with a comprehensive estimate and verifiable cause of Loss, the Carrier chose to deny the Insureds’ valid Claim. The Carrier violated the provisions of Florida Statute §626.9541(1)(i)(2) by materially misrepresenting to the Insureds that Policy coverage was unavailable for the Insureds’ Claim and Loss to the Insured Property. This misrepresentation was made in an attempt to deny the Insureds’ Claim and escape without paying for the full extent of substantial damage. The Carrier violated the provisions of Florida Statute §626.9541(1)(i)(3)(a) by failing to adopt and implement standards for the proper investigation of claims. When confronted with a comprehensive estimate and verifiable cause of Loss, the Carrier apparently had no system or standards prepared or implemented which would allow it to evaluate the Claim as submitted by its Insureds. The Carrier violated the provisions of Florida Statute §626.9541(1)(i)(3)(b) by misrepresenting pertinent facts or Policy provisions relating to the coverage at issue. This has been discussed fully hereinabove. The Carrier violated the provisions of Florida Statute 626.9541(1)(i)(3)(d) by denying the Insureds’ Claim without conducting reasonable investigation into the basis for the Claim. The Carrier violated the provisions of Florida Statute 626.9541 (1)(i)(3)(f) by failing to promptly provide a reasonable explanation in writing to the Insureds of the basis in the Policy, in relation to the facts or applicable law, for denial of the Claim. The Carrier has refused to properly assess its payment of benefits and the basis of payment and has refused to properly adjust and settle the claim constituting unfair claim settlement practices under Florida Statute §626.9541(1)(i)(3)(i). The Carrier can cure these violations by payment, within 60 days of the date hereof, of all funds contractual owed to the Insured under the terms and conditions of the Policy.
Comments
User Id Date Added Comment
taylor@floridainslaw.com 01-22-2025 The Carrier has resolved the Civil Remedy Notice to the satisfaction of the Insureds, and the Insureds hereby withdraw the instant CRN.
tacham@hpmanaging.com 01-07-2025 January 7, 2025 Via E-mail & Posting on DFS Website Michael Ciocchetti, Esq. 125 N. Ridgewood Ave., Suite 100 Daytona Beach, FL 32114 firm@floridainslaw.com RE: Complainant(s): Susan and Carol Bracken Insured(s): Susan Stanley and Carol Bracken Claim No: HO0522412002 Policy No: FE-0000830893-04 DFS Filing Number: 791068 Acceptance Date: November 8, 2024 Insurer: Monarch National Insurance Company To Whom it May Concern: Please allow this correspondence to serve as Monarch National Insurance Company’s (“Monarch”) official response to the Civil Remedy Notice of Insurer Violations (“Notice”). Monarch maintains that it has not been in any violation of the law and that the Notice is defective on its face and fails to comply with the specificity requirements under Florida Statute 624.155. As such, Monarch objects to the Department’s acceptance of the above-referenced Notice. Monarch has acted in good faith and with due regard for the insured’s interests, and denies each and every allegation contained in the Notice. Monarch denies any wrongdoing in the adjustment and handling of the above-referenced claim, and denies any and all allegations that it committed any acts or violated any Florida statutes or law. Monarch has acted in good faith and in accordance with the terms and provisions of the applicable policy of insurance as well as with the law. Please note that nothing herein should be deemed as a waiver by Monarch. Monarch hereby expressly reserves all rights without exception or limitation. If you require additional information, please contact me. Sincerely, /s/ Tyler Acham, Esq. Tyler Acham In-House Counsel Monarch National Insurance Company
Acknowledgement
* The submitter hereby states that this notice is given in order to perfect the rights of the person(s) damaged to pursue civil remedies authorized by Section 624.155, Florida Statutes.

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DFS-10-363
Rev. 10/14/2008